Patients who are hospitalized with medical conditions related to opioid use disorder (OUD) may benefit from treatment after hospitalization in a post-acute medical care facility. These facilities have been cited for violating the Americans with Disabilities Act (ADA) for discriminating against patients with OUD, a recognized disability, defined as a physical or mental impairment that substantially limits a major life activity. This cohort study of patients hospitalized with conditions related to their OUD determined the proportion of referrals to post-acute medical care facilities that discriminated against patients based on their OUD or engagement with opioid agonist treatment (OAT). The authors also assessed if prior ADA settlements against these facilities affected these practices.
- 15% of all referrals were deemed to discriminate, citing OUD or engagement with OAT as the reason for admission denial.
- 4 out of 10 patients with OUD were not accepted at a post-acute medical care facility due to their OUD or engagement with OAT.
- Among the facilities receiving referrals, 29% were deemed to express discrimination in their reason for admission rejection.
- There was no difference in proportion of discriminatory rejections before and after ADA settlement.
Comments: Despite federal and state protections for individuals with disabilities such as substance use disorder, discrimination against people with OUD is widespread in post-acute medical care facilities. Continued advocacy is needed to improve these patients’ access to care, particularly as hospitalizations among this population rise.
Melissa Weimer, DO, MCR
Reference: Kimmel SD, Rosenmoss S, Bearnot B, et al. Rejection of patients with opioid use disorder referred for post-acute medical care before and after an anti-discrimination settlement in Massachusetts. J Addict Med. 2020 [Epub ahead of print]. doi: 10.1097/ADM.0000000000000693.